Women wait too long, see their clinicians too briefly, and receive too little of what actually matters. It is time to redesign prenatal care with intelligence, not inertia.
Dr. Grunebaum is absolutely correct. Unfortunately ACOG OR SMFM Continue to base quality of care on the number of visits rather than the quality of visits. All the suggestions provided are doable and will SAVE overworked and over booked clinicians time. One area not mentioned is collaborative care with the MFMs who are obstetricians to provide a obstetrical care when they are doing a first trimester scan, a second trimester scan and a growth scan so the patient doesn’t have to go to the MFM one day and then the Ob the next. Questions can be answered by nurses and education can be accomplished with NPS. ALL of this is a win for the patients and a win for the doctors. I don’t understand why this cannot be supported by both ACOG AND SMFM.
Agreed: ACOG and SMFM continue to emphasize visit quantity over visit quality as a measure of prenatal care adequacy, despite evidence that this approach burdens both patients and clinicians without improving outcomes. Consider the reality for a pregnant woman: she wakes early, showers, eats breakfast, gets dressed, arranges childcare or time off work, travels to the office, finds parking, checks in, completes paperwork, waits 45–60 minutes in the reception area, sees her physician for 5 minutes, waits again for nursing instructions, completes additional paperwork, and travels home—a process consuming a MINIMUM of 3–4 hours for a 5-minute clinical encounter. Until these organizations prioritize patient-centered efficiency and interprofessional collaboration over traditional metrics, pregnant women will continue to navigate a fragmented system that wastes their time, strains their resources, and serves neither their needs nor those of their providers.
I remember in 1977 when I worked for Kaiser for 10 months after my army discharge my schedule often had 5 prenatal appointments in a single 15 minute time slot. I always ran late.
Above article fails to address the socio-economic factors that impact access and availability of actual prenatal care to varying groups of women. This is a large limiting factor with anything considered “good” prenatal care. Not sure if AI can meet the challenges of the changing healthcare environment.
Dr. Grunebaum is absolutely correct. Unfortunately ACOG OR SMFM Continue to base quality of care on the number of visits rather than the quality of visits. All the suggestions provided are doable and will SAVE overworked and over booked clinicians time. One area not mentioned is collaborative care with the MFMs who are obstetricians to provide a obstetrical care when they are doing a first trimester scan, a second trimester scan and a growth scan so the patient doesn’t have to go to the MFM one day and then the Ob the next. Questions can be answered by nurses and education can be accomplished with NPS. ALL of this is a win for the patients and a win for the doctors. I don’t understand why this cannot be supported by both ACOG AND SMFM.
Agreed: ACOG and SMFM continue to emphasize visit quantity over visit quality as a measure of prenatal care adequacy, despite evidence that this approach burdens both patients and clinicians without improving outcomes. Consider the reality for a pregnant woman: she wakes early, showers, eats breakfast, gets dressed, arranges childcare or time off work, travels to the office, finds parking, checks in, completes paperwork, waits 45–60 minutes in the reception area, sees her physician for 5 minutes, waits again for nursing instructions, completes additional paperwork, and travels home—a process consuming a MINIMUM of 3–4 hours for a 5-minute clinical encounter. Until these organizations prioritize patient-centered efficiency and interprofessional collaboration over traditional metrics, pregnant women will continue to navigate a fragmented system that wastes their time, strains their resources, and serves neither their needs nor those of their providers.
I remember in 1977 when I worked for Kaiser for 10 months after my army discharge my schedule often had 5 prenatal appointments in a single 15 minute time slot. I always ran late.
This was one of the reasons I left.
Exactly. It sucks..... Happened to me many times
Above article fails to address the socio-economic factors that impact access and availability of actual prenatal care to varying groups of women. This is a large limiting factor with anything considered “good” prenatal care. Not sure if AI can meet the challenges of the changing healthcare environment.
Prenatal visits themselves are mostly useless. Prenatal care is essential- let’s just do it in a better way.